Meniscal (Cartilage) Tear
What is a meniscal (cartilage) tear?
The meniscus is a piece of cartilage in the middle of your knee. Cartilage is tough, smooth, rubbery tissue that lines and cushions the surface of the joints. You have a meniscus on the inner side of your knee (the medial meniscus) and a meniscus on the outer side of the knee (the lateral meniscus). Each meniscus attaches to the top of the shinbone (tibia), makes contact with the thighbone (femur), and acts as a shock absorber during weight-bearing activities. If a meniscus tears, it can cause knee pain and can limit motion.
How does it occur?
A meniscal tear can occur when the knee is forcefully twisted or sometimes with minimal or no trauma, such as when you are squatting.
What are the symptoms?
Symptoms may include the following:
- You have pain in your knee joint.
- You have immediate swelling with fluid in the joint, called an effusion.
- You can't fully bend or straighten your leg.
- Your knee locks or gets stuck in one place.
- You hear a snap or pop at the time of the injury.
A chronic (old) meniscal tear may give you pain on and off during activities, with or without swelling. Your knee may sometimes lock, and you may have stiffness in the knee.
How is it diagnosed?
Your healthcare provider will review your symptoms and how the injury occurred. He or she will ask about your medical history and examine your knee. Your provider will move your knee in several ways that may cause pain along the injured meniscal surface. You may have X-rays to see if the bones in your knee are injured, but a meniscal tear will not show on an X-ray. An MRI scan can help diagnose a meniscal tear.
How is it treated?
To treat this condition:
- Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
- Raise the knee on a pillow when you sit or lie down.
- Wrap an elastic bandage around your knee to keep the swelling from getting worse.
- Wear a knee immobilizer or other brace as directed by your provider.
- Use crutches to prevent further injury while the meniscus heals.
- Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
- Your provider may give you an injection of a corticosteroid medicine. This will not fix the torn meniscus but may relieve your symptoms temporarily.
While you are recovering from your injury, you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to swim instead of run.
Arthroscopic surgery is needed to repair or remove large torn pieces of cartilage. The surgery usually takes about an hour. An arthroscope is a tube with a light on the end that projects an image of the inside of your knee onto a TV screen. By putting tools through the end of the arthroscope, the healthcare provider can usually repair or remove the damaged meniscus. Because the meniscus is a valuable shock absorber, the provider will leave as much of the healthy portion of the meniscus as possible during surgery.
You will go home the day of the surgery. You should keep your leg elevated. Take it easy for at least the next 2 to 3 days.
Do not take part in strenuous activities until your healthcare provider advises that you are ready.
How long will the effects last?
If you have a small tear that has not been repaired or removed, you may still be able to function well and be active. However, your knee may sometimes swell, lock, be stiff, or hurt during activities.
If you have surgery, you will need to spend time rehabilitating your knee. Everyone recovers at a different rate, depending on the severity of the injury and their general health. Many people return to their previous level of activity within a month or so after surgery.
When can I return to my normal activities?
Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. The goal is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.
You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:
- your injured knee can be fully straightened and bent without pain
- your knee and leg have regained normal strength compared to the uninjured knee and leg
- your knee is not swollen
- you are able to bend, squat, or walk without pain
How can a meniscal tear be prevented?
To help prevent knee cartilage injuries, it helps to have strong thigh and hamstring muscles, and to stretch your legs before and after exercising. In activities such as skiing, be sure your ski bindings are set correctly by a trained professional so that your skis will release when you fall.
Written by Pierre Rouzier, MD, for RelayHealth.
Published by RelayHealth.
© 2012 RelayHealth and/or its affiliates. All rights reserved.